Oral Answers to Questions

Debate between Alex Chalk and Kevin Hollinrake

Thursday 18th November 2021 Commons Chamber

[Kevin Hollinrake (Thirsk and Malton) (Con)]

10. What steps the CPS is taking to help improve prosecution rates for serious crime.

[The Solicitor General (Alex Chalk)]

Through its three national central casework divisions and 13 regional complex casework units, the CPS continues to work with the National Crime Agency and other criminal justice partners to bring offenders to justice for a range of serious crimes, including serious and organised crime, terrorism, and serious and complex economic crime.

[Kevin Hollinrake]

The Serious Fraud Office has made clear that a new criminal offence of failure to prevent economic crime would significantly increase the number of successful prosecutions for fraud. What steps are we taking to bring that about?

[The Solicitor General]

My hon. Friend is right to raise this issue. Economic crime is not a victimless crime; it strikes at the very heart of the society that we want to be. I am pleased to see that the Law Commission published its discussion document on corporate criminal liability earlier this year. Both the CPS and the SFO provided input, and took part in a series of events to share their operational insights. The Law Commission is aiming to publish an options paper early next year, and will then work with the Government to implement any next steps.

Oral Answers to Questions

Debate between Alex Chalk and Kevin Hollinrake

Tuesday 29th June 2021 Commons Chamber

[Kevin Hollinrake (Thirsk and Malton) (Con)]

What steps his Department is taking to help ensure that appropriate compensation is disbursed to Medomsley Detention Centre victims.

[The Parliamentary Under-Secretary of State for Justice (Alex Chalk)]

I have every sympathy for the survivors and victims of Medomsley detention centre, who suffered abhorrent abuse. The Ministry of Justice has been working for several years to compensate properly survivors and victims. Where necessary, claimants are able to submit medical evidence to support allegations of abuse so that damages can be appropriately assessed. That includes both physical and psychological injury. The majority of claims for compensation have now been settled under a settlement protocol.

[Kevin Hollinrake]

I am grateful for that answer. The compensation scheme covers physical, not sexual abuse. My constituent suffered terrible, much more serious abuse. He was drugged and raped, which has had a profound effect on his health for over 40 years—both his physical and his mental health—and that of his family. Will my hon. Friend agree to meet me, my constituent and the chair of the all-party parliamentary group on Medomsley detention centre to discuss a proper compensation settlement for my constituent?

[Alex Chalk]

I am very grateful to my hon. Friend for that question, and he paints a truly harrowing picture. For the avoidance of doubt, cases involving serious sexual harm and psychological injury can be dealt with by the Government Legal Department, albeit outside the standard compensation scheme. Because of their seriousness and complexity, they are considered on a case-by-case basis and awards made have been significant. We take great care to ensure the level of compensation properly reflects the seriousness of the abuse. It is of course always open to claimants to issue proceedings in the courts outwith the scheme, should they see fit. I would be happy to meet to discuss the protocols, but I just say this: it is important that Ministers do not interfere in specific cases when litigation is ongoing.

Regional Transport Infrastructure

Debate between Alex Chalk and Kevin Hollinrake

Tuesday 5th March 2019 Westminster Hall

[Kevin Hollinrake (Thirsk and Malton) (Con)]

It is a pleasure to serve under your chairmanship, Ms Ryan, and to follow the hon. Member for Barnsley Central (Dan Jarvis). I thank him for securing the debate. I will touch briefly on devolution, which has proven to be the most intractable political situation in Yorkshire—much more so than Brexit—over the past five or 10 years. However, I am sure that there is a way forward, and I agree with the hon. Gentleman that it is crucial that we find it, so that we can properly exert our influence over central Government on hugely important matters, such as transport investment in our counties.

As the Chancellor admitted in his Budget speech in November 2016, no other major developed country has as large a productivity gap between its capital and its second and third cities as the UK. We are the most regionally imbalanced nation, which is a huge issue that we must deal with. London is 50% more productive than the regions of England—not only the north—and has 50% higher wages, on average, than the north. There is a direct correlation there. This is not about spending for spending’s sake; it is about the prosperity of the people we represent. There is no doubt that infrastructure spending has been disproportionately higher in the capital than in the regions, and redressing that imbalance will transform the economy right across the UK.

[Alex Chalk (Cheltenham) (Con)]

Does my hon. Friend agree that, in seeking to redress that imbalance, it is critical to present an ask, as it were, to the Department for Transport? When the Cheltenham cyber-park needed transport infrastructure, the Department provided £22 million, showing that, where there is a clear goal to improve infrastructure, it is keen to help where it can.

[Kevin Hollinrake]

I totally agree. I will come shortly to the clear ask, which has been set out for us by Transport for the North.

The Government are doing much. By 2021, infrastructure investment spending as a percentage of GDP will be at its highest for the last 30 years, while the national productivity investment fund will increase to £37 billion by 2023-24. The Government recognise that this is an issue. We must always make sure that we spend wisely and, in many cases, the minimum amount, because this is taxpayers’ money.

However, in my view there is a difference between recurrent spending—much of which is important but which we clearly have to keep under control, making sure that we run a surplus, rather than a deficit—and investment spending. A business would treat the two things differently in its accounts. Businesses have balance sheets and they also look at profit and loss. Investment spending goes on the balance sheet. We should look at investment spending in our regions in a completely different light from other types of spending, particularly in the north.

I support Transport for the North’s recent strategic plan. The hon. Member for Barnsley Central rightly referred to £3 being spent per capita in London for every £1 spent per capita in the north. However, it is not all to do with central Government spending or central allocations. Much of it is about local authority spending and private sector investment. It is important that we recognise that difference. Nevertheless, Transport for the North’s strategic transport plan sets out very clearly the £70 billion of spending needed between now and 2050, which would contribute an extra £100 billion gross value added to our economy and 850,000 jobs. That is a compelling case, as my hon. Friend the Member for Cheltenham (Alex Chalk) referred to earlier.

Yes, part of it is about Northern Powerhouse Rail, which is so important to connect Liverpool to Manchester, to Bradford, to Leeds, to Hull and to Scarborough, and to go up into the north-east as well, but when that is delivered is also key. I would like my hon. Friend the Minister to consider, if possible, in his closing remarks when Northern Powerhouse Rail will be delivered, because the key ask in the Transport for the North strategic plan is that it be delivered to coincide with High Speed 2 delivery in 2033, and that would involve bringing forward the very important Northern Powerhouse Rail plan.

I again congratulate the hon. Member for Barnsley Central on initiating the debate. I look forward to listening to further contributions.

Privatisation of NHS Services

Debate between Alex Chalk and Kevin Hollinrake

Monday 23rd April 2018 Westminster Hall

[Alex Chalk]

I am grateful to the hon. Lady. I respect her past record and her contributions to the House. There is an ongoing debate among clinicians—no doubt colleagues of hers—about what the NHS should cover. Most of the clinicians I speak to would welcome a more open, non-partisan and grown-up debate about the full extent of the NHS, but the guiding principle should not be confused. Whatever it is that the NHS can provide, the core principle is that it will provide it to individuals in our country regardless of their personal circumstances. I am at pains to emphasise that, because from listening to some of the contributions of Opposition Members—no doubt made entirely sincerely, but made none the less—one could be confused into thinking that that principle was under attack. It is not, and it never will be.

The debate is about the delivery of a common goal. Many take the view, with some justification, that we should be open to solutions that deliver that goal most effectively for patients. Last year, the respected and politically independent King’s Fund wrote in its report:

“Provided that patients receive care that is timely and free at the point of use, our view is that the provider of a service is less important than the quality and efficiency of the care they deliver.”

When debating this important question, we should not rewrite history. As the hon. Member for Ealing North (Stephen Pound) has conceded, it is a fact that certain services have been provided independently since the NHS’s inception 70 years ago. Most GP practices are private partnerships; the GPs are not NHS employees. Equally, the NHS has long-established partnerships for the delivery of clinical services such as radiology and pathology, and non-clinical services such as car parking and the management of buildings and the estate. To give an everyday example, the NHS sources some of its bandages from Elastoplast. That is common sense. It would be daft if public money was diverted away from frontline patient care to research and reinvent something that was already widely available. It would be just as daft if the NHS had to do the same for its water coolers or hand sanitisers.

As the King’s Fund put it in its 2017 report:

“These are not new developments. Both the Blair and Brown governments used private providers to increase patient choice and competition as part of their reform programme, and additional capacity provided by the private sector played a role in improving patients’ access to hospital treatment.”

Throughout Europe there are healthcare systems that offer high-quality care, free at the point of use, and make use of far greater numbers of private providers than the UK.

I want to say a few words about the impact on my constituents in Cheltenham. I will give three brief examples. First, Cobalt is a Cheltenham-based medical charity that is leading the way in diagnostic imaging. It provides funding for research, including into cancer and dementia, which it does as part of a research partnership with the ²gether NHS Foundation Trust. It assists with training for healthcare professionals, and it even provided the UK’s first high-field open MRI scanner, which is designed for claustrophobic and larger patients. Are we seriously suggesting that is an affront to patient care in Cheltenham? Not a bit of it. Are we seriously suggesting that getting rid of it would be a good idea? Emphatically no.

Secondly, we have the Sue Ryder hospice at Leckhampton Court, which is a 16-bed hospice that delivers truly excellent care in the Gloucestershire countryside. It also provides hospice-at-home services. It also supports, as I know, family, carers and close friends. It is part-funded by the NHS and by charitable donations. It shows astonishing compassion, but also creativity and innovation in how it delivers care. The third example is Macmillan and its nurses. I need say no more about it—it is a fantastic organisation. To suggest that these independent providers and charities are somehow not good for patient care is to stretch a political principle beyond breaking point.

We also need to slay the myth—there was just a glimmer of it today, but it was not really developed—that somehow different types of providers are held to different standards. All providers are held to the same standards and given rigorous Ofsted-style inspections and ratings by the Care Quality Commission. For my constituents in Cheltenham, I want to see resources allocated as effectively as possible to free up resources for facilities such as A&E at Cheltenham General Hospital, which can only be delivered there. There is growing demand for A&E in Cheltenham, and the service needs to be 24/7.

It is right to say, however, that there are some legitimate concerns that can be properly addressed. The experience of Carillion has laid bare the chaos that can be caused when private providers take on significant contracts and then fail to deliver. We have to recognise that the consequences of failure in health services would not simply be an unfinished construction project, important though that is, but could be a decline in the quality of patient care. I mention that only because community services are disproportionately served by independent providers, but let us keep this in context. Based on a survey of 70% of CCGs in 2015, Monitor published analysis in its report, “Commissioning Better Community Services for NHS Patients”, showing that independent providers were responsible for just 7% of contracts. We should be vigilant, not dogmatic and quasi-religious in our approach. The NHS as a whole must ensure that no contract ever becomes too big to fail and that contingencies are always in place to cater for such an eventuality.

[Kevin Hollinrake]

My hon. Friend is making a very fine speech. He mentioned the failure of Carillion. There are many lessons from that and many reasons behind the failure. One is that Carillion worked on wafer-thin margins in its contracts, which illustrates that the taxpayer gets very good value for money because of the competitive nature of the bidding process.

O’Neill Review

Debate between Alex Chalk and Kevin Hollinrake

Tuesday 7th March 2017 Westminster Hall

[Kevin Hollinrake]

Yes, what we need is a mixture of solutions. The UK by its own admission is mid-range across Europe in its use of antibiotics in agriculture. That is one thing, but we have been world leaders on this issue and for me mid-range is not where we need to be; we need to be at the forefront and world leaders in terms of best practice, whatever aspect of this issue we are dealing with.

There are four key recommendations in the O’Neill review’s 10 main recommendations. The last one is on market entry rewards to solve the problem of pharmas not investing in research and development, as well as a possible levy on drug companies that do not invest in research.

[Alex Chalk (Cheltenham) (Con)]

The World Health Organisation has made it clear, chillingly, that resistance to last resort antibiotics is present globally, so we have to act. Does my hon. Friend agree that we will not create vital new drugs until we align better the public health needs with the commercial incentives, and that Governments need to correct what is the most dangerous market failure in history?

[Kevin Hollinrake]

That is correct, and the review sets that out clearly. At the moment, if there is not a commercial return, it is difficult for pharmaceutical companies to invest in this field, although some are. For example, AstraZeneca recently sold its late-stage small molecule antibiotic business to Pfizer and so stepped out of research and development, but others, such as MSD, are still investing. It cannot be right that some companies are willing to invest—perhaps for altruistic purposes—when others are not. The O’Neill review discusses whether there should be a reimbursement or an insurance model, so that pharmaceutical companies can be sure that they will get a certain amount every year for drugs if they do develop them. It cannot be right that some contribute and some do not, so a levy for those that do not seems sensible to me. I do not think it should be left simply to big pharma to solve the problem.

The O’Neill review talks about a global AMR innovation fund—GAMRIF—to make funding available for smaller third sector organisations. Having Antibiotic Research UK, the world’s first charity in this field, in my constituency is how the issue was brought to my attention. It is doing fantastic research. From donations made by individuals, it has got hundreds of thousands of pounds that it is investing in “resistance breakers”, which is blending drugs together to repurpose existing antibiotics. That again is one of the recommendations in the report. Yes, big pharma, but we have also got to make some funding available to the smaller organisations, too.

Health and Social Care

Debate between Alex Chalk and Kevin Hollinrake

Monday 27th February 2017 Commons Chamber

[Kevin Hollinrake (Thirsk and Malton) (Con)]

It is a pleasure to follow the hon. Member for West Lancashire (Rosie Cooper), who made some interesting points, particularly about fundamental reform of services, which I will address later in my remarks.

Members on both sides of the House have alluded to the fact that this debate is set against the background of hugely increasing demand and, in many ways, decreasing supply, particularly in adult social care, to which I will restrict my comments. I was interested to take part in the Communities and Local Government Committee inquiry, to which the Chair, the hon. Member for Sheffield South East (Mr Betts), referred. On increasing demand, there was a 33% increase in the past 10 years in the population who are aged 80 and over. There is a projected 100% increase in that population over the next 20 years, and a 50% increase in 65s and over in the same period. Interestingly enough, there will be only a 4% increase in the population who are below the age of 65 over the next 20 years. That is an interesting dynamic when we think about who will provide the care that will be needed for all the people who are getting older.

An area of adult social care we can sometimes forget—it has not been mentioned—is care for those with learning disabilities. That population is increasing rapidly and will increase again over the next 20 years, which means more profound challenges for our health and adult social care services.

On the backdrop of the decreasing supply of provision, everybody has to take part in ensuring that the books balance. We are reducing the deficit from £156 billion a year in 2010 to around £68 billion this year, which is no mean feat. We must understand that there is no bottomless pit, and that we have to make difficult decisions on allocating our spending.

Local authorities have borne the brunt of the 37% reduction in overall spending—it is a 25% reduction after council tax increases. Adult social care accounts for around 33% of local authority discretionary spend. It is therefore inevitable that that will be a focus when local authority managers try to balance the books. There are other competing pressures, such as the national living wage, which soaks up a lot of the extra money allocated to adult social care. It is not just about local authorities: providers are also under huge pressure. Some 59% of care homes are below the profitability threshold. Homes are closing and some providers are returning their contracts to local authorities.

There are other elements relating to the provision of what we would call a well-functioning health and social care service. Other reductions include a 28% reduction in the number of community nurses, who provide the key services that stop people going into the health and social care system. In my constituency, simple things like sitting services, local dementia clubs or something called Kurt’s Club in my hometown of Easingwold have either closed or had services reduced in recent weeks and months. Again, that puts more pressure on the system.

Delayed discharges also have an impact on the NHS. Hon. Members who spoke earlier know far more about this than I do, but when Simon Stevens gave evidence to our Committee he estimated that the NHS spends up to an extra £1 billion due to delayed discharges. There is an impact on the whole system.

The Government have responded with £2 billion more since 2010, with the adult social care precept, the better care fund and the adult social care grant adding between £3.5 billion and £4 billion by 2020. There is no doubt, however, that all the evidence we have heard from a number of different sources—the King’s Fund and the like—points to an investment shortfall of between £1 billion and £2 billion.

[Alex Chalk (Cheltenham) (Con)]

On the shortfall, does my hon. Friend agree that the time has come to bite the bullet and increase social care funding? Does he agree that doing so in the short term would provide the financial headroom to enable trusts like mine in Gloucestershire to achieve the meaningful reconfiguration of services through the STPs that will reflect the changing health priorities and demographics? It is a sprat to catch a mackerel.

[Kevin Hollinrake]

My hon. Friend makes a very strong point. I do feel that we need more money now. I am sure the question of whether more money might be available is taking up some of the Chancellor’s time as he works on his Budget calculations for 8 March. In the short term, we need more money to plug the gap. In the longer term, we need a cross-party conversation on how we solve this problem.

The Select Committee has been an excellent forum through which to explore this issue and many others. As the hon. Member for Sheffield South East (Mr Betts), the Committee Chair, mentioned in his remarks, we went to Germany to examine its system. It was very enlightening. In 1995, Germany moved from one system to another: from a local government-funded system that just did not work—they clearly saw this coming before we did—to a social insurance system. They are more used to that system in Germany, which has similar systems in place for health, pensions, unemployment and accident insurance. It works very well. It is cross-party, seems to be apolitical and takes a salary contribution of about 1.175%. It is a bit like auto-enrolment, but it is compulsory—it is a mandatory scheme. It means that when people need care they have a pot to call on. Needs are independently assessed, so they receive the level of provision that suits them. It can also be used to provide domiciliary care. Money coming back out of the system at the right time can go to help family members look after the person who is ill, so it has a social benefit as well as being a sustainable system that works in the longer term. We should look at that model. It is not the only one, but I reiterate—I know Members on both sides of the House feel the same way—that we should look at this issue in a cross-party way to ensure long-term sustainability.